Unilateral Forgiveness and the Task of Reconciliation

Although forgiveness is often taken to bear a close connection to the value
of reconciliation, there is a good deal of scepticism about its role in situations where there is no consensus on the moral complexion of the past and no admission of guilt on the part of the perpetrator. This scepticism is typically rooted in the claims that forgiveness without perpetrator acknowledgement (1) aggravates the risk of recidivism; (2) yields a substandard and morally compromised form of political accommodation; and (3) comes across as patronizing and offensive to the recipient, thereby causing further alienation. In this article, my aim is to show, firstly, that none of these arguments is decisive and, secondly, that forgiveness is a suitable object of political concern in the
absence of cross-community consensus on the rights and wrongs of a conflict. In this way, I aim to demonstrate that forgiveness deserves to be taken seriously as a means to civic reconciliation in a broader range of situations than many have allowed.

‘Marxism and Ecology: From Political Economy to Political Ecology’

One of the reasons for the 'fin de seicle' angst within western liberal capitalist societies is the rise in prominance of ecological concerns within these societies. Long before the New Right declared the post-war welfare state to be untenable, early green critics had claimed it to be ecologically unsustainable. The addiction of the welfare state on ever increasing levels of economic growth was pronounced to be simply impossible within the context of a finite planet. Although it was not expressed in this manner, what these early ecological concerns with Limits to Growth were in effect saying was that the accumulation of capital rendered capitalism unsustainable. Yet the ecological critique of capitalism has not found much favour within the Marxist critique untile recently. Early Marxist analyses of the ecology movement dismissed them as ‘petty bourgeios radicals’ while many greens still view Marxism as ‘fair shares in extinction’. The lack of positive engagement and dialogue between Marxism and ecology has in recent years been put right with a discernable overlap between the two critiques of capitalism. This article seeks to present the areas of disagreement and agreement between the two and seeks to provide an ‘environmental audit’ on both the Marxist method and political project.

The Many Directions of Time

Event duration perception is fundamental to cognitive functioning. Recent research has shown that localized sensory adaptation compresses perceived duration of brief visual events in the adapted location; however, there is disagreement on whether the source of these temporal distortions is cortical or pre-cortical. The current study reveals that spatially localized duration compression can also be direction contingent, in that duration compression is induced when adapting and test stimuli move in the same direction but not when they move in opposite directions. Because of its direction-contingent nature, the induced duration compression reported here is likely to be cortical in origin. A second experiment shows that the adaptation processes driving duration compression can occur at or beyond human cortical area MT+, a specialised motion centre located upstream from primary visual cortex. The direction-specificity of these temporal mechanisms, in conjunction with earlier reports of pre-cortical temporal mechanisms driving duration perception, suggests that our encoding of subsecond event duration is driven by activity at multiple levels of processing.

Tracing emotion: an overview

Computational research with continuous representations depends on obtaining continuous representations from human labellers. The main method used for that purpose is tracing. Tracing raises a range of challenging issues, both psychological and statistical. Naive assumptions about these issues are easy to make, and can lead to inappropriate requirements and uses. The natural function of traces is to capture perceived affect, and as such they belong in long traditions of research on both perception and emotion. Experiments on several types of material provide information about their characteristics, particularly the ratings on which people tend to agree. Disagreement is not necessarily a problem in the technique. It may correctly show that people’s impressions of emotion diverge more than commonly thought. A new system, Gtrace, is designed to let rating studies capitalise on a decade of experience and address the research questions that are opened up by the data now available.

Moral Compromise

A moral compromise is a compromise on moral matters; it is agreement in the face of moral disagreement but where there is agreement on the importance of consensus – namely that it secures a morally desirable outcome. It is distinguishable from other forms of agreement, and an important distinction between moral compromise with public agreement and moral compromise with public disagreement is also made. Circumstances in which the former might be permissible are outlined, and the sense in which it is allowed all things considered to agree is made clear. The relevant discussions of Dan Brock and Mary Warnock on the role of the philosopher to public policy are critically reviewed. Finally, a brief list is offered of the considerations relevant to an estimation of whether and, if so, when such compromise is allowed.

Comparison of API20C with molecular identification of Candida spp isolated from bloodstream infections

A study was carried out to compare the API20C technology with polymerase chain reaction amplification and direct sequencing of the short internal transcribed spacer region 2 (ITS2) for the identification of 58 isolates of invasive candida species obtained from patients with bloodstream infections over the seven year period 1994 to 2000. Overall, there was only one disagreement between the phenotypic and genotypic identification, where the API scheme identified the isolate as C albicans but the molecular method identified it as C dubliniensis. This study demonstrated that the API20C method is useful in the identification of Candida spp isolated from blood culture and that molecular methods do not enhance identifications made using the API20C scheme. However, for correct reporting of C dubliniensis, an emerging bloodborne pathogen, it is recommended that all isolates identified as C albicans by the API20C scheme are further examined phenotypically and/or genotypically.

Agreement between self-report and medical records on signs and symptoms of respiratory illness

Background: Information on patient symptoms can be obtained by patient self-report or medical records review. Both methods have limitations. Aims: To assess the agreement between self-report and documentation in the medical records of signs/symptoms of respiratory illness (fever, cough, runny nose, sore throat, headache, sinus problems, muscle aches, fatigue, earache, and chills). Methods: Respondents were 176 research participants in the Hutterite Influenza Prevention Study during the 2008-2009 influenza season with information about the presence or absence of signs/symptoms from both self-report and primary care medical records. Results: Compared with medical records, lower proportions of self-reported fever, sore throat, earache, cough, and sinus problems were found. Total agreements between self-report and medical report of symptoms ranged from 61% (for sore throat) to 88% (for muscle aches and earache), with kappa estimates varying from 0.05 (for chills) to 0.41 (for cough) and 0.51 (for earache). Negative agreement was considerably higher (from 68% for sore throat to 93% for muscle aches and earache) than positive agreement (from 13% for chills to 58% for earache) for each symptom except cough where positive agreement (77%) was higher than negative agreement (64%). Agreements varied by age group. We found better agreement for earache (kappa=0.62) and lower agreements for headache, sinus problems, muscle aches, fatigue, and chills in older children (aged =5 years) and adults. Conclusions: Agreements were variable depending on the specific symptom. Contrary to research in other patient populations which suggests that clinicians report fewer symptoms than patients, we found that the medical record captured more symptoms than selfreport. Symptom agreement and disagreement may be affected by the perspectives of the person experiencing them, the observer, the symptoms themselves, measurement error, the setting in which the symptoms were observed and recorded, and the broader community and cultural context of patients. © 2012 Primary Care Respiratory Society UK. All rights reserved.

Intercepting the First Pass:Rapid Categorization is Suppressed for Unseen Stimuli

The operations and processes that the human brain employs to achieve fast visual categorization remain a matter of debate. A first issue concerns the timing and place of rapid visual categorization and to what extent it can be performed with an early feed-forward pass of information through the visual system. A second issue involves the categorization of stimuli that do not reach visual awareness. There is disagreement over the degree to which these stimuli activate the same early mechanisms as stimuli that are consciously perceived. We employed continuous flash suppression (CFS), EEG recordings, and machine learning techniques to study visual categorization of seen and unseen stimuli. Our classifiers were able to predict from the EEG recordings the category of stimuli on seen trials but not on unseen trials. Rapid categorization of conscious images could be detected around 100?ms on the occipital electrodes, consistent with a fast, feed-forward mechanism of target detection. For the invisible stimuli, however, CFS eliminated all traces of early processing. Our results support the idea of a fast mechanism of categorization and suggest that this early categorization process plays an important role in later, more subtle categorizations, and perceptual processes.

Age related differences in mental health scale scores and depression diagnosis: Adult responses to the CIDI-SF and MHI-5.

Inconsistencies surrounding the prevalence levels of depression in later life suggest that the measurement of depression in older people may be problematic. The current study aimed to map responses to a depressive symptom scale, the Mental Health Index-5 (MHI-5) which is part of the Short form 36 (SF-36, Ware et al., 1993) against the diagnostic screening items of the Composite International Diagnostic Instrument-Short Form (CIDI-SF, Kessler et al., 1998) to examine disagreement rates across age groups. The study examined data from a national random sample of 10,641 participants living in Ireland, 58.8% were female and 19% were over 65 (SLÁN, 2007). CIDI-SF depression screening endorsement was lower in older groups, whereas mean MHI-5 depressive symptoms showed less change across age groups. Results showed that the odds of MHI-5 endorsers aged 18–44 endorsing CIDI-SF screening questions were 5 times and 4.5 times (dysphoria and anhedonia, respectively) greater than the odds of people aged 75 or more endorsing these items. Findings suggest that although the risk of depressive disorder may decrease with age, complex diagnostic screening questions may exaggerate lower rates of depression among older people.

The progenitor mass of the Type IIP supernova SN 2004et from late-time spectral modeling

SN 2004et is one of the nearest and best-observed Type IIP supernovae, with a progenitor detection as well as good photometric and spectroscopic observational coverage well into the nebular phase. Based on nucleosynthesis from stellar evolution/explosion models we apply spectral modeling to analyze its 140-700 day evolution from ultraviolet to mid-infrared. We find a M_ZAMS= 15 Msun progenitor star (with an oxygen mass of 0.8 Msun) to satisfactorily reproduce [O I] 6300, 6364 {\AA} and other emission lines of carbon, sodium, magnesium, and silicon, while 12 Msun and 19 Msun models under- and overproduce most of these lines, respectively. This result is in fair agreement with the mass derived from the progenitor detection, but in disagreement with hydrodynamical modeling of the early-time light curve. From modeling of the mid-infrared iron-group emission lines, we determine the density of the "Ni-bubble" to rho(t) = 7E-14*(t/100d)^-3 g cm^-3, corresponding to a filling factor of f = 0.15 in the metal core region (V = 1800 km/s). We also confirm that silicate dust, CO, and SiO emission are all present in the spectra.

'Whatever You Say, Say Nothing' : Researching Memory & Identity in Mid-Ulster, 1945-1969

The influence of collective memory on political identity in Ireland has been well documented. It has particular force in Northern Ireland where there is fundamental disagreement about how and why the conflict erupted and how it should be resolved. This article outlines some of the issues encountered by an ‘insider’ when attempting to record and analyse the conflicting memories of a range of Protestants and Catholics who grew up in Mid-Ulster in the decades preceding the Troubles. In particular, it considers the challenges and opportunities presented by a two-pronged approach to oral history: using testimony as evidence about historical experience in the past and as evidence about historical memory – both collective and individual – in the present.

Belfast beyond violence: Flagging up a challenge to local government?

Northern Ireland is emerging from violence but still living with conflict. The recent flags protests in Belfast represent a challenge to public administration to transcend the contested politics of local government in Northern Ireland and to navigate a way through a symbolic legacy issue. This article draws on a longitudinal hermeneutic analysis of empirical research conducted on Northern Ireland local government over a decade, where these concerns dominated much debate. Additional analysis of the research findings reveals broader problems applicable to any public administration faced with managing situations in which good governance in public participation and procedural correctness operates alongside fundamental political disagreement and distrust. These conclusions are particularly pertinent for local administrations in societies transitioning from conflict.

Optical Coherence Tomography for the Monitoring of Neovascular Age-Related Macular Degeneration: A Systematic Review

Topic

To compare the accuracy of optical coherence tomography (OCT) with alternative tests for monitoring neovascular age-related macular degeneration (nAMD) and detecting disease activity among eyes previously treated for this condition.

Traditionally, fundus fluorescein angiography (FFA) has been considered the reference standard to detect nAMD activity, but FFA is costly and invasive. Replacement of FFA by OCT can be justified if there is a substantial agreement between tests.

Systematic review and meta-analysis. The index test was OCT. The comparator tests were visual acuity, clinical evaluation (slit lamp), Amsler chart, color fundus photographs, infrared reflectance, red-free images and blue reflectance, fundus autofluorescence imaging, indocyanine green angiography (ICGA), preferential hyperacuity perimetry, and microperimetry. We searched the following databases: MEDLINE, MEDLINE In-Process, EMBASE, Biosis, Science Citation Index, the Cochrane Library, Database of Abstracts of Reviews of Effects, MEDION, and the Health Technology Assessment database. The last literature search was conducted in March 2013. We used the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) to assess risk of bias.

We included 8 studies involving more than 400 participants. Seven reported the performance of OCT (3 time-domain [TD] OCT, 3 spectral-domain [SD] OCT, 1 both types) and 1 reported the performance of ICGA in the detection of nAMD activity. We did not find studies directly comparing tests in the same population. The pooled sensitivity and specificity of TD OCT and SD OCT for detecting active nAMD was 85% (95% confidence interval [CI], 72%–93%) and 48% (95% CI, 30%–67%), respectively. One study reported ICGA with sensitivity of 75.9% and specificity of 88.0% for the detection of active nAMD. Half of the studies were considered to have a high risk of bias.

There is substantial disagreement between OCT and FFA findings in detecting active disease in patients with nAMD who are being monitored. Both methods may be needed to monitor patients comprehensively with nAMD.

Barriers to Goals of Care Discussions With Seriously Ill Hospitalized Patients and Their Families: A Multicenter Survey of Clinicians

Importance: Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored to existing barriers.

Objective: To determine, from the perspective of hospital-based clinicians, (1) barriers impeding communication and decision making about goals of care with seriously ill hospitalized patients and their families and (2) their own willingness and the acceptability for other clinicians to engage in this process.

Design, Setting, and Participants: Multicenter survey of medical teaching units of nurses, internal medicine residents, and staff physicians from participating units at 13 university-based hospitals from 5 Canadian provinces.

Main Outcomes and Measures: Importance of 21 barriers to goals of care discussions rated on a 7-point scale (1 = extremely unimportant; 7 = extremely important).

Results: Between September 2012 and March 2013, questionnaires were returned by 1256 of 1617 eligible clinicians, for an overall response rate of 77.7% (512 of 646 nurses [79.3%], 484 of 634 residents [76.3%], 260 of 337 staff physicians [77.2%]). The following family member-related and patient-related factors were consistently identified by all 3 clinician groups as the most important barriers to goals of care discussions: family members' or patients' difficulty accepting a poor prognosis (mean [SD] score, 5.8 [1.2] and 5.6 [1.3], respectively), family members' or patients' difficulty understanding the limitations and complications of life-sustaining treatments (5.8 [1.2] for both groups), disagreement among family members about goals of care (5.8 [1.2]), and patients' incapacity to make goals of care decisions (5.6 [1.2]). Clinicians perceived their own skills and system factors as less important barriers. Participants viewed it as acceptable for all clinician groups to engage in goals of care discussions-including a role for advance practice nurses, nurses, and social workers to initiate goals of care discussions and be a decision coach.

Conclusions and Relevance: Hospital-based clinicians perceive family member-related and patient-related factors as the most important barriers to goals of care discussions. All health care professionals were viewed as playing important roles in addressing goals of care. These findings can inform the design of future interventions to improve communication and decision making about goals of care.

Prescribing for children and adolescents in mental health

The level of psychiatric prescribing in children and adolescents is increasing; however, rates of adherence in this group of patients range from only 34–54%. The possible consequences of untreated psychiatric problems include longer duration of the illness, increased severity of symptoms, higher relapse rates, greater risk of suicidal behaviour, academic difficulties and increased family conflict. Prescribers are often faced with difficulty if the parent or carer is not in agreement with the use of medication. This parental disagreement has implications for medication concordance and the relationship between clinicians, young people and their families. For prescribers, understanding parental and young people's attitudes towards medication and their experiences of mental health services is central to patient-centred care.